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The association between income distribution and measures of health has been well established such that societies with smaller income differences between rich and poor people have increased longevity (Wilkinson, 1996). While more egalitarian societies tend to have better health, in most developed societies people lower down the social scale have death rates two to four times higher than those nearer the top. Inequities in income distribution and the consequent disparities in health status are particularly problematic for many women, including single mothers, older women, and women of colour. The feminization of poverty is the rapidly increasing proportion of women in the adult poverty population (Doyal, 1995; Fraser, 1987).

We have entered a new moment of negotiation over gender, class and women's relationship to work at home and for pay that will shape policy formation in coming decades. I argue that underlying such debate is a profound transformation of women's labor. Focusing on the United States, I outline the recent breakdown of the gender division of labor among women of all backgrounds which has accompanied women's turn to paid work in the post-World War II years, and its consequences for both the market economy and the realization of new social policy. Women's move from household to wage work, like men's shift off the land, is opening struggles to replace lost arrangements for care, while also providing new legitimation and leverage for such rights. However, uneven breakdown of the gender division of labor, accentuating differences of race/ethnicity and class, threatens to derail such efforts. This perspective furthers development of a dynamic historical dimension in gender and social policy formation.